With rise in teen depression, experts advise parents to teach coping skills to their children

As studies show rise in teen depression, experts say parents, schools need to open lines of communication and provide kids the help they need. (Elisabetta Stoinich / Getty Imag / Getty Images)

You monitor their growth and have their teeth, blood pressure and vision checked regularly.

But what about their mental health? Do you pay close attention to that and take steps to keep it well?

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There are plenty of reasons parents should be concerned about their teens’ emotional and psychological well-being these days, said Gabrielle Roberts, a licensed clinical psychologist in pediatrics at Advocate Children’s Hospital in Oak Lawn.

For one, teens are under a lot of stress, she said.

For another, the rise in depression among teens, she added, “is staggering.”

One study shows a spike in depression among teen girls. Another states there also is an increase in depression among adolescent boys, only the symptoms are displayed differently.

In addition, we’re learning more about how long-term effects of bullying, which can lead to depression and isolation, might have compelled some young men to become shooters, she said.

According to a Pew Research Center analysis of data from the 2017 National Survey on Drug Use and Health, the total number of teens experiencing depression increased 59% between 2007 and 2017, with the rate of growth faster for teen girls (66%) than for boys (44%).

Roberts said the spike is likely due to a number of factors, including better reporting, less stigma attached to talking about it and the rise in popularity of social media.

Sometimes depression is short-term and caused by a situation, she said. Sometimes it is biological, hormonal or genetic -- it just happens. It doesn’t make a parent at fault; It doesn’t make a child at fault, she said.

“We know that a greater use of social media has been linked to depression but of course that doesn’t mean one leads to the other. It could be that individuals who are more depressed are using more social media,” she said.

Girls may be more vulnerable, she said, for several reasons.

“As much as society is evolving, girls are still second-class citizens in a lot of ways,” she said. “As much as we have the #metoo movement, there’s still a lot of emphasis on physical appearance in terms of how females are valued. Tie that into the puberty piece: what does that do to a girls’s sense of self and how she values herself?”

Using more social media leaves you more available to cyber bullying, she said. Unfortunately, she said, most kids have been subjected to that.

Life used to be more compartmentalized, she said. If something embarrassing happened at school, it stayed at school. A kid could home and at least get a break from the stress, she said. But round the clock access to social media means bullying can be 24/7 as well, she said.

“Home is not a safe place anymore for kids who are being bullied,” she said. "It follows them everywhere. Things don’t go away.

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“And there’s this added pressure to maintain your online presence. It isn’t enough to be presentable in person, now you have to have a status. It has to show who you are online and what you’re demonstrating with your life,” she said. “It’s a lot of pressure.”

But social media also can be a respite for some, she added.

“I work with kids who really value digital communication,” she said. Some kids who would otherwise be isolated are finding communities on social media.

“It’s definitely being heavily looked it when it comes to explaining this impact on depression, though,” she said.

Experts say parents can help their children navigate adolescence by keeping the lines of communication open. (Letizia Le Fur / HANDOUT)

Meanwhile, parents and kids should strive for balance and ongoing conversation. Talking, she said, often offers clues to how a kid is doing.

“I think kids are balancing a lot. Our job is to kind of help them learn how to live as healthy and balanced as they can while also solving these problems,” she said.

If parents are concerned, she said, school can be a great place to start getting help. Reaching out to the school and asking a social worker to meet with their child can be very helpful, she said.

Importance of being heard

Nadjeh Awadallah, clinical director of Community High School District 218′s INSPIRE program, said in addition to the PEW study, another piece of research by The Journal of American Medicine in Primary Care looks at gender discrepancy in the way depression symptoms are displayed and social expectations.

Female subjects struggling with depression, he said, described a recurrence of guilt, self-punishment, worthlessness, low energy, fatigue. Depressed boys, on the other hand, reported irritability, apathy and suicidal thoughts, he said.

People might not consider that an irritable or apathetic teen boy is depressed and needs to be connected with services, Awadallah said.

The INSPIRE Clinic trains teachers and staff to address social, emotional, behavioral and neurological variables impacting student success. It also provides help to students in the district’s high schools -- Richards, Eisenhower and Shepard -- and its feeder schools through psychological assessment, intervention and outpatient therapy.

“In the old days, people might say just snap out of it or it’s all in your head, but really there’s a neurochemical component to people experiencing emotional distress. Some people have predispositions to different disorders as well,” Awadallah said.

Nadjeh Awadallah is clinical director of Community High School District 218's INSPIRE program, which provides help to students in the district’s high schools -- Richards, Eisenhower and Shepard -- and its feeder schools through psychological assessment, intervention and outpatient therapy. (Bob McParland/District 218) (HANDOUT)

“So making sure people have access to resources just makes sense. School is a stressful environment. There are a lot of responsibilities kids have to meet, a lot of social interactions they have to navigate. Giving them as many resources as possible in order for them to come forward and address things is our goal,” he said.

They do that through relationship building, which can make students feel comfortable talking about the things that distress them, he said.

“One thing I’m noticing, when you are able to get people to be open about what they see in the hallways and what they’re dealing with, it helps,” he said.

Open communication leads to mindfulness, which he describes as “not being on autopilot, being attentive to the reality of what’s happening at the moment and the details of that.”

Awadallah said, “It’s really important to allow people to feel they have a voice and that their voice will be heard. If they feel ignored they’ll probably be less likely to speak up when there’s something to speak up about.”

Preventing the extreme

Roberts said for decades, there have been people who have been abused, had horrible childhoods and experienced bullying. Those aren’t new phenomena. What’s happening now to create a “shooter” phenomenon, she said, could be acerbated by the “contagion effect.”

Despite increased awareness about the rise in teenage depression, most who have it are not being treated, she said.

Like suicidal contagion, Roberts said, she suspects there is shared depression experience today that didn’t necessarily exist before because of online communities.

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“People can maybe feel depressed and go online and connect with others who are feeling depressed and that may not be positive in terms of how their mental health is affected. There can be clusters in which people sort of feed off each other,” she said.

On the one hand, she said, a depressed person can go online and find a source of support because there are others like him. But on the other, she added, it can prevent that person from seeking professional help and possibly perpetuate the depression.

"It can become sort of an identity. It might mean coping in the wrong way,” she said.

“A support group is a great thing but if there’s no intervention, that could make you feel more sad,” she said. “It’s different from group therapy in which there’s a therapist directing intervention.”

“Make them understand that you’re empathetic to their situation and that it’s not an adversarial thing and that they can tell you what’s going on at school and that they can tell you candidly and speak candidly about how they’re reacting to it,” he said. “The stronger the connections are, the more opportunities they’ll have to address something before it becomes untenable.”

Roberts said there are lots of ways adults can help their children through adolescence, and the rest of their lives.

Teach them pro-social (empathy, concern for others) and coping skills so they can better handle stress, she said.

Help them strive for balance with school, extracurriculars, friends and social media, she said. And teach them about healthy relationships and boundaries, she added.

Mostly, she said, establish open lines of communication. Start early. And begin by listening.

“Teens often don’t want to share things with parents for fear that they will end up with a lecture,” Roberts said. “It might be helpful to save unsolicited feedback for another conversation. Try asking: ‘Do you want a suggestion or do you just want to vent?’”

Be patient, vary the conversation format because making eye-contact can be awkward sometimes, she said, “and don’t just talk about the heavy stuff.”

Remember that today’s teens face different challenges than their parents did, she said. “Parents don’t have to be ‘all knowing;’ it’s OK to ask questions and team up together with the child to problem solve challenges.”

Above all, she said, let your children know that they can always come to you if they need help -- no matter what.